MEDICARE: DR. MICHAEL P SKADRON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10636	MN

General Provider Information

NPI Number	:	1285714436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL P SKADRON DDS

Provider Business Mailing Address
First Line	:	4103 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2259
Country	:	US
Telephone Number	:	612-721-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	4103 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2259
Country	:	US
Telephone Number	:	612-721-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1144150384 — DR. JACK DAILEY DDS
Practice Location Address:

4103 E LAKE ST
MINNEAPOLIS, MN
55406-2259

Practice Phone: 612-721-2424
Practice Fax:

1033223581 — WEST RIVER DENTAL CARE
Practice Location Address:

4103 E LAKE ST
MINNEAPOLIS, MN
55406-2259

Practice Phone: 612-721-2424
Practice Fax: 612-721-3054

1023238904 — MRS. MARLA CATHERINE KENNEDY MA LP LMFT
Practice Location Address:

4103 EAST LAKE ST.
MINNEAPOLIS, MN
55406-2259

Practice Phone: 651-645-6020
Practice Fax: 651-645-6020

1932576238 — HERITAGE TRANSPORTATION, INC.
Practice Location Address:

4103 E LAKE ST
MINNEAPOLIS, MN
55406-2259

Practice Phone: 612-728-8080
Practice Fax:

1063020931 — GRANDPA & GRANDMA ADULT DAY CARE, INC.
Practice Location Address:

2518 N 2ND ST STE 116
MINNEAPOLIS, MN
55411-2259

Practice Phone: 952-564-1311
Practice Fax:

1790501617 — PEACE OF MIND CARE CENTER
Practice Location Address:

2518 N 2ND ST STE 116
MINNEAPOLIS, MN
55411-2259

Practice Phone: 952-564-1131
Practice Fax:

Directions to “ DR. MICHAEL P SKADRON DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.